不同术式治疗闭角型青光眼合并白内障的疗效比较

目的:比较不同手术方式治疗闭角型青光眼合并白内障的手术效果及对患者生活质量的改善作用.方法:收集2014-01/2016-10我院收治的60例60眼闭角型青光眼合并白内障患者的临床资料,按手术方式分为对照组(单纯小梁切除术,n=28)、观察组(小梁切除术+超声乳化白内障吸除术+人工晶状体植入术,n=32),比较两组患者手术前后视力、眼压的变化,统计术后并发症发生率,比较两组患者生活质量.结果:术前,两组患者视力、眼压、前房深度对比,差异无统计学意义(P>0.05).术后4wk,两组患者视力上升,眼压降低,观察组前房深度增加,对照组前房深度降低,与同组术前比较差异有统计学意义(P<0.05);观察组术后4wk视力、前房深度高于对照组,眼压低于对照组,差异有统计学意义(P<0.05).观察组手术成功率、术后房角开放率高于对照组,但差异无统计学意义(P>0.05).观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05).术前,两组患者生活质量评分比较,差异无统计学意义(P>0.05);术后4wk,3mo,两组患者评分均上升(P<0.05);观察组术后不同时间生活质量评分均高于对照组,差异有统计学意义(P<0.05).结论:采用小梁切除术+超声乳化白内障吸除术+人工晶状体植入术治疗闭角型青光眼合并白内障患者,手术成功率高,同时可改善患者视功能,降低术后并发症发生率,提升患者生活质量.

Clinical value of different surgeries in the treatment of angle closure glaucoma with cataract

AIM: To compare the effects of different surgeries in the treatment of angle closure glaucoma with cataract and the improvement of quality of life.

METHODS: The clinical data of 60 cases(60 eyes)with angle closure glaucoma and cataract who were admitted to the hospital between January 2014 and October 2016 were collected. According to the surgical method, they were divided into the control group(simple trabeculectomy, n=28)and the observation group(trabeculectomy combined with phacoemulsification and intraocular lens implantation, n=32). The changes of visual acuity and intraocular pressure before and after surgery were compared between the two groups. The incidence of postoperative complications was statistically analyzed, and the quality of life was compared between the two groups.

RESULTS: Before surgery, there was no significant difference in visual acuity, intraocular pressure and anterior chamber depth between the two groups(P>0.05). At 4wk after surgery, the visual acuity of two groups increased and intraocular pressure decreased. The anterior chamber depth of observation group increased while that of the control group decreased(P<0.05). At 4wk after surgery, the visual acuity and anterior chamber depth of observation group were higher than that of the control group but intraocular pressure was lower than that of control group(P<0.05). The success rate of surgery and the opening rate of chamber angle after surgery in the observation group were higher than those in the control group(P>0.05). The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05). Before surgery, there was no statistically significant difference in quality of life score between the two groups(P>0.05). At 4wk and 3mo after surgery, the scores of the two groups increased(P<0.05), and the quality of life scores of observation group were higher than those of the control group at different time(P< 0.05).

CONCLUSION: The success rate of trabeculectomy combined with phacoemulsification and intraocular lens implantation is high in the treatment of angle closure glaucoma with cataract. The regimen can improve the visual function, reduce the incidence of postoperative complications, and improve the quality of life of patients.